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    Association of polycystic ovary syndrome with mammographic density in Turkish women: a population-based case-control study
    (Assoc Medica Brasileira, 2023) Senkaya, Ayse Rabia; Ari, Sabahattin Anil; Karaca, Ibrahim; Kebapci, Eyup; Ismailoglu, Eren; Oztekin, Deniz Can
    OBJECTIVE: The objective of this study was to investigate the breast densities and Breast Imaging-Reporting and Data System scores of patients with polycystic ovary syndrome and normoovulatory women and to determine whether these patients constitute a high-risk population for breast cancer.METHODS: This retrospective case-control study was conducted at our institution between January 2022 and December 2022, involving patients diagnosed with polycystic ovary syndrome. Menstrual periods, hyperandrogenemic findings, and ultrasound reports of the patients were retrieved from our hospital's database. Patients who met at least two of the Rotterdam criteria were included in the polycystic ovary syndrome group. A total of 70 premenopausal patients over the age of 40 years, diagnosed with polycystic ovary syndrome, and 70 normoovulatory women, matched for age and body mass index, were included in the study. The two groups were compared regarding age at menarche, menstrual pattern, gravida, parity, levels of follicle-stimulating hormone, luteinizing hormone, and estradiol, endometrial thickness, breast density category, and Breast Imaging-Reporting and Data System classifications.RESULTS: Patients in the polycystic ovary syndrome group had a higher age at menarche (12.7 vs. 12.3, p=0.006). There was no difference between the gonadotropin levels in both groups. However, the estradiol level was higher in the polycystic ovary syndrome group (p<0.001). There was no statistically significant difference between the two groups in terms of breast density and Breast Imaging-Reporting and Data System scores (p=0.319 and p=0.650, respectively).CONCLUSION: Although we can conclude that the risk of breast malignancy is not increased in patients with polycystic ovary syndrome, the impact of the complex hormonal status of polycystic ovary syndrome on breast cancer remains unclear in the literature.
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    CoronaVac vaccine does not affect ovarian reserve
    (Via Medica, 2023) Senkaya, Ayse Rabia; Cil, Zafer; Keskin, Omur; Gunes, Mehmet Emin; Oztekin, Deniz Can
    Objectives: In this study, our aim is to investigate the effect of CoronaVac vaccine on ovarian reserve in female patients followed up for infertility.Material and methods: Our study is a retrospective study. Forty-six infertile patients who received two doses of CoronaVac vaccine one month apart and had not had a previous Covid 19 infection were included in the study. Anti-mullerian hormone (AMH) and folliculometry of 46 patients one month before CoronaVac vaccine and one month after the second dose of vaccine were compared. Results: There was no statistically significant difference in the change of AMH level and follicle number before and after vaccination (respectively p = 0.366; 0.610).Conclusions: Considering that having a COVID-19 infection has a negative effect on female fertility and causing ovarian damage in recent studies, vaccination is a rational and cost-effective approach to protect ovarian reserve. Knowing that the vaccine does not have a negative effect on fertility may increase the application of the vaccine in women of reproductive age.
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    Early Initiation and Long-Term Use of Vaginal Progesterone may Cause Gestational Diabetes Mellitus
    (Georg Thieme Verlag Kg, 2022) Oztekin, Deniz; Senkaya, Ayse Rabia; Gunes, Mehmet Emin; Keskin, Omur; Dogdu, Irmak Atci
    Background Preterm birth (PTB) is an important cause of neonatal mortality and morbidity. Spontaneous PTB (sPTB) is the most common cause of PTB. In patients with a singleton pregnancy, progesterone treatment appears to reduce the rate of spontaneous preterm birth in those with a previous history of spontaneous preterm labor and/or cervical shortening in the current pregnancy. Progesterone therapies used for the prevention of sPTB may increase the risk of gestational diabetes mellitus (GDM) towards the end of pregnancy owing to their effects on carbohydrate metabolism. Aim We aimed to show the effects of vaginal progesterone use, starting time, and duration of treatment on GDM. Methods A retrospective cohort study was carried out in pregnant women 18 to 39 years old who came to our hospital between January 1, 2021, and August 31, 2021, and who had a 2- hour 75-g oral glucose tolerance test (OGTT) at 24 to 28 weeks of gestation. In a total of 540 patients, 68 were diagnosed with GDM based on at least one abnormal plasma glucose value at screening. The remaining 472 patients with normal plasma glucose levels were considered as the control group. The groups were compared in terms of age, parity, pre-pregnancy body mass index (BMI), smoking, gestational age, and vaginal progesterone use. Patients using vaginal progesterone with and without GDM were then compared again in terms of indications for vaginal progesterone use, initiation time of progesterone therapy, duration of progesterone use, and cervical length. Results The incidence of GDM in our study group was 12.5 %. Despite the use of vaginal progesterone at a higher rate in the GDM group than in the control group (23.5 vs. 13.9 %; p = 0.07), it was not statistically significant. When we examined patients using progesterone as a subgroup analysis, the mean time to start vaginal progesterone treatment was 19.8 +/- 2.6 (14-24), and it was significantly earlier in the GDM group (18.1 +/- 2.0 vs. 20.2 +/- 2.6; p = 0.007). Initiation of vaginal progesterone before 20 weeks of gestation was statistically significantly more frequent in the GDM group than the control group (68.8 vs. 39.4 %; p = 0.050 OR :3.3, 95 %CI: 1.0-10.8). The mean duration of vaginal progesterone use was 50.0 +/- 15.6 days (28-90) and it was longer in the GDM group (57.8 +/- 13.4 vs. 48.1 +/- 15.6; p = 0.027). Conclusion Since the duration of vaginal progesterone use will be prolonged, there may be a risk of GDM, especially in patients who started vaginal progesterone before the 20th week of pregnancy. Even if the OGTT test performed between 24-28 weeks is normal, it should be kept in mind that these patients may have GDM in the later weeks of pregnancy, and repeating the OGTT test should be considered if necessary.
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    The effect of maternal anxiety during delivery on birth outcomes
    (2021) Abacı, Hüseyin; Karabulut, Alaattin; İleri, Alper; Aytaç, Hakkı; Öztekin, Deniz Can; Senkaya, Ayse Rabia; Karaca, Suna Yıldırım
    Birth anxiety can be defined as the fear of direct pain, the fear of the birth process. The aim of this study is to investigate the effect of anxiety level at the time of birth on the birth process and maternal and neonatal outcomes. Materials and Methods: Anxiety scores of the patients were recorded. Demographic data of the patients, cervical examination findings, place of residence, education level, type of delivery, APGAR score, presence of episiotomy or dehiscence in normal deliveries, 1st, 2nd and 3rd stages of labor, analgesia needs, prenatal and postnatal hemoglobin variability were recorded. The patients were divided into two groups as those with low (n=76) and moderate/high (n=24) anxiety levels, and the effect of anxiety level on birth outcomes was compared. Results: 53.9% (n=41) of pregnant women with low level of anxiety were nulliparous, and 91.7% (n=22) of patients with moderate/high level of anxiety were nulliparous (p=0.001). Postpartum hemoglobin change in pregnants with low level of anxiety, was higher than the pregnant women with moderate/high level of anxiety (p=0.00). A statistically significant relationship was found between age and anxiety level, the anxiety score of younger pregnant women was significantly higher (p=0.001). Conclusion: Although we did not find a statistically significant relationship between prepartum anxiety level and fetal and neonatal outcomes in our study, the amount of bleeding was less in pregnant women with low anxiety. We also concluded that previous birth experience and maternal age affect the anxiety score.
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    A prospective cohort study: can advanced ultrasonography replace magnetic resonance imaging in the diagnosis of placental adhesion disorders?
    (Walter De Gruyter Gmbh, 2023) Ari, Sabahattin Anil; Suner, Asli; Senkaya, Ayse Rabia; Okmen, Firat; Akdemir, Ali; Ergenoglu, Ahmet Mete
    Objectives: To define and compare the diagnostic accuracy of ultrasonography (USG) and magnetic resonance imaging (MRI) for the placental adhesive disorder (PAD). Methods: A prospective study was conducted between January 2019 and February 2020 in a tertiary referral university hospital. A total of 115 placenta previa cases were included in the study during the third trimester of gestation. USG examination was performed, and the placenta was scanned in a systematic manner using gray-scale ultrasound, color Doppler flow mapping, and 3-D imaging for each participant. Thereafter, all participants underwent an MRI examination. USG and MRI findings were compared with histopathological findings. Results: Loss of the retroplacental sonolucent zone (71% [95% CI 47-88]) and an irregular retroplacental sonolucent zone (71% [95% CI 47-88]) were the most sensitive USG parameters. For MRI, the uterine bulging parameter was the most sensitive (60% [95% CI 36-80]) and specific (91% [95% CI 83-96]) findings, and it had the highest accuracy rate (85% [95% CI 77-91]). Overall, the USG sensitivity, specificity, and accuracy rates were 77% (95% CI 54-92), 87% (95% CI 79-93), and 85% (95% CI 77-91), respectively. The MRI sensitivity, specificity, and accuracy rates for all participants were 81% (95% CI 59-94), 85% (95% CI 76-92), and 84% (95% CI 76-90), respectively. Conclusions: In the diagnosis of PAD, the specificity and accuracy of USG are higher than that of MRI, whereas the sensitivity of MRI is better than that of USG.